ABSTRACT
The present study, conducted in collaboration between the Departments of Psychiatry in Swiss Universities and the World Health Organization, had two main goals: to develop assessment methods which could subsequently be used in the Swiss centres in a standard manner; and to make arrangements for continuing collaboration between the centres in Switzerland and the acquisition of new knowledge about the distinctions between depression and cognitive impairment. For this aim, three different groups of elderly patients of either sex were selected during the period of November 1989 to July 1991 for inclusion in the study. The first two groups included the first ten patients of either sex over 60 years of age consecutively contacting the participating institutions and showing depression with or without clinically significant symptoms of cognitive impairment; the control group included patients showing no depression or clinically significant symptoms of cognitive impairment. A total of 125 patients were included in the initial evaluation, 69 of which were reassessed at a seven-month follow up (on average). Each patient was administered a number of clinician-rated or self-report instruments for the assessment of depression, cognitive impairment, disabilities, physical status and onset of disorders. The study has shown that a variety of instruments can be used for the reliable assessment of depression or cognitive impairment in the elderly; but the instruments for the assessment of depression differentiate only poorly between patients with or without cognitive impairment. Because of the importance of identifying both depressed and cognitively impaired patients among the elderly, different assessment instruments targeted at the different symptom clusters need to be administered simultaneously.
ABSTRACT
Increasingly, gerontologists are recognizing the need to counteract the detrimental effects which prevalent attitudes toward age have on programs for the elderly. A familiar example is the widespread but misguided view that old age is a medical condition best treated as a terminal illness. Challenging such noxious misconceptions, the authors point out that old age--by the same token as infancy, childhood, adolescence, adulthood and mid-life--is a natural phase in human development, with its own strengths and weaknesses, wisdom and shortcomings, joys and sorrows, problems and solutions and, above all, its own rightful place in the natural scheme of things. Remarking that the accumulation of knowledge alone does little or nothing to improve the quality of life, they launch an appeal for redoubled efforts to find practical measures to help the elderly adjust to their particular phase of development. They suggest that such efforts would be greatly facilitated by having the elderly participate actively in the development of their own programs, particularly if their participation encompasses concepts which can infuse meaning into life as a whole.
